SUICIDE AMONG PHYSICIAN-PATIENTS

Abstract

On the psychiat-ric inpatient service at the Minneapolis VA [Veterans Administration] Hospital during the past 20 years 36 physicians had been patients. Five of them, or 13.8%, subsequently committed suicide. This paper represents a special study of these 5 patients. An attempt is made to elucidate any factors which might have been useful in predicting the high suicide risk among these 5 patients, in contrast to 10 others who revealed suicidal preoccupation during their hospitalization. The average MMPI [Minnesota Multiphasis Personality Inventory] profile for the 15 suicidal physician-patients was in marked contrast to that found in other studies of suicidal preoccupation. The physician-patients tended to deny personal distress or psychological discomfort. Their propensities toward suicide may be well covered and in this sense make them difficult treatment prospects. Three of the 5 patients who committed suicide received diagnoses of manic-depressive illness, with many recurrent episodes and much intensive therapy. Suicide for them could be interpreted as 1 possible response to insoluble emotional problems. The other 2 suicides carried the diagnosis of personality disorder, with episodes of acting out behavior and marked defensiveness in admitting psychological problems. These patients, because of their elaborate denial system, closed themselves off to any effective therapeutic intervention. These 2 diagnostic categories, in this study at least, constituted a high suicide risk. None of the neurotic patients committed or attempted suicide. No schizophrenic patient in this study ended his life by self-destruction.